Clinico-Laboratory Profile and Response to Current Treatment Regimens of Malaria in South Eastern Rajasthan

ABSTRACT

ntroduction Malaria continues to be one of the importantpublic health problems in India. Rajasthan is an endemic zoneof malaria with still a high prevalence rate. A revisedknowledge of present scenario of malaria is almost undercontrol. This prospective study was conducted to analyzevarious types of presentation of Malaria in adults, itscomplications and response to current treatment regimensavailable.Materials and Methods: This cross sectional study wascompleted over a period of 12 months; from 1st November2015 to 31st December 2016; carried out in Department ofMedicine RNT medical college and attached group of hospitalsUdaipur (Raj). 200 patients who presented with fever andassociated symptoms with test positive for malaria by slideand/or MPQBC (Malaria Parasite Quantitative buffy coat) andinclusion criteria were enrolled in the study. These patientswere then subjected to treatment regimens with regular vitalmonitoring and laboratory tests. The main method to establishdiagnosis was microscopy of PBF, however MPQBC helped indiagnosis of cases missed on slide examination and mixedinfections. The presence of various complications, treatmentresponse and outcome was studied.Results & Conclusion: P. falciparum was the major parasitetype causing malaria as 56% cases. All complications cerebralmalaria, respiratory distress, haematological, malariahepatopathy, acute renal failure and electrolyte disturbanceswere noted in greater frequency in P. falciparum. Howevereven P. vivax accounted for complicated cases of malaria inthis region. For dysnatremia, hyponatremia was more commonthan hypernatremia with increase frequency amongstP.falciparum cases and higher in cerebral malaria. There was agood response to artesunate and quinine drug with 2nd linedrugs. However 14 patients in artesunate group weresubsequently shifted to quinine based therapy after treatmentfailure. A total of 4 deaths were reported all P.falciparumpositive. However an early diagnosis and adequate treatmentwith antimalarials with timely supportive therapy withHemodialysis and blood component transfusion can save livesin malaria.